Do your best to obtain the full SSN (this is required by the state). If the SSN is still unobtainable the field can be completed with "9's". This should not be a consistent practice, however, every effort should be made before defaulting to using the "9's". If the information should become available at a later date an update CCAR should be submitted.

What is the difference in discharge reasons between client initiated and administrative termination?
An administrative termination is used when a client has not been seen at the mental health center for 90 days or more and future contact seems unlikely. A client initiated termination is used when a client refuses further services and the clinician believes they could still benefit from services or when a contact has been lost with a client for less than 90 days but the clinician feels future contact is unlikely and wishes to discharge the client.

Yes, things like aggressive behavior toward others, being expelled from pre-school or childcare settings should be scored as problems in socialization. Just keep in mind that the child's behavior should be compared to other children of the same age and cultural background.

As with SSN, every attempt should be made to obtain this information. If it is not possible, a "0" should be submitted in this field. If the information should become available at a later date an update CCAR should be submitted.

As with other domains, the Cognitive Domain should be scaled based on how mental health symptoms affect functioning. Therefore, an individual experiencing cognitive difficulties due to dementia (a physical health concern) alone should not have an elevated score on this domain. Other mental health factors such as depression that contribute to cognitive problems should impact scoring of this domain.

Yes, the definition remains as: History of non-family perpetrated trauma, being exposed to traumatic event(s) or environment in which individual experienced, witnessed or confronted event(s) that involve the threat of death or serious physical injury (e.g. earthquake, shooting, torture, or bombing).

Although there is not a lower level possible on the CCAR, changes in mental health functioning can be measured using finer gradations on the domain scores. Accurate scoring of the CCAR at all times is critical to overall data collection and should not be compromised in order to demonstrate greater change due to placement or treatment.